# HERNANDEZ-AMB MEDICAL CLINIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508354515
- **Authorized official:** MRS. JUANITA HERNANDEZ MD (DIRECTOR)
- **Authorized official phone:** (787) 479-9968

## Contact information

- **Practice address:** CARR. 926 KM. 0.4, BO. COLLORES, LAS PIEDRAS, PR 00771
- **Practice address phone:** (787) 733-2716
- **Practice address fax:** (787) 733-2716
- **Mailing address:** PO BOX 487, LAS PIEDRAS, PR 00771-0487
- **Mailing address phone:** (787) 733-2716
- **Mailing address fax:** (787) 733-2716

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |

## Other

- **Enumeration date:** 04/25/2018
- **Last updated:** 05/03/2018